From the mechanisms of obstacle avoidance towards the prevention of falls.

Abstract

The problem of falls in the elderly has become a topic of growing scientific interest. Numerous studies on risk factors for falls and preventive strategies have been published in the past decades. The development of fall prevention interventions has usually been based on these known risk factors. Another approach would be to develop an intervention program that is mainly based on the reported circumstances of falls. Such interventions would typically include elements like obstacle course walking, because a large number of falls in the elderly are a consequence of tripping and stumbling over obstacles while walking. The first aim of this thesis was to evaluate the effectiveness of a new falls prevention exercise program for the elderly, which was called the Nijmegen falls prevention program. This exercise program was developed from the perspective of training in an exercise environment that simulated the most frequently reported circumstances of falls, such as obstacles that are encountered while walking. In order to enhance the probability of success of such intervention programs, it may help to get a better understanding of why elderly fall over obstacles. The second aim of this thesis was to provide more knowledge about the characteristics of obstacle avoidance under time pressure and about the influence of divided attention and aging on this task. Finally, the ultimate goal of the prevention of falls is the prevention of fall injuries. The third aim of this thesis was to explore whether the practice of martial arts fall techniques could potentially contribute to the prevention of fall injuries in the elderly